Cervical Herniated Disc
Arm pain from a cervical herniated disc is one of the more common conditions treated by spine specialists. This condition usually develops in the 30-to-50-year-old age group. Your herniated cervical disc may originate from a trauma or injury to the cervical spine; however, the symptoms, including arm pain, generally start unexpectedly.
The most common symptom of a cervical herniated disk is neck pain that radiates or spreads from your neck down to your arm. The specific location of the arm pain depends on which disk is involved. You might also experience a feeling like pins and needles in your arm, and in some cases weakness of some of the arm muscles is exhibited.
After an initial physical examination, special diagnostic imaging tests may be required to confirm your diagnosis. An excellent tool to identify this condition is a magnetic resonance imaging (MRI) scan.
Although a CT scan with myelogram is more sensitive, it is also a slightly invasive test, as the myelogram dye must be injected into the spinal canal as part of the procedure. Because of the injection, a CT scan with myelogram is not usually the first test ordered. Plain CT scans (without myelogram) are in general not useful for the diagnosis of a cervical herniated disc.
Treatment of your disk problem can be divided into two categories—conservative or non-surgical and surgical. Occasionally, surgery can also be considered a conservative option in cases of very large disc herniation causing significant pressure on your spinal cord.
Examples of conservative treatment options that may be prescribed include:
Physical therapy consisting of traction, mild stretching, heat, massage, or ultrasound
Home cervical traction
Referral to a pain management specialist
Injections in and around the cervical spine
Studies show that up to 95% of patients will improve with conservative treatment and will not require surgery.
Surgical treatment is reserved for patients who exhibit the signs and symptoms that require urgent decompression. Patients who cannot or do not wish to spend the time to allow conservative approaches to work may also be considered for surgery. If your pain fails to respond to conservative management after six to eight weeks, surgery could be recommended.
Surgery for a cervical herniated disc is divided into two approaches, anterior from the front and posterior from the back. Since the disk is located in front of the spinal cord, the anterior approach is the more direct method.
The most common anterior procedure is the anterior discectomy and fusion (ACDF). The disk is removed and typically replaced with a small piece of bone. Sometimes, metal plates and screws may be used to support the fusion. Depending on the type of surgery performed, you may need to wear a cervical collar for a prescribed length of time.
The posterior approach is much less commonly performed. In this surgery, a small amount of bone is removed from the back of the spine over the affected nerve root. Gentle retraction may allow removal of a soft disc. Few surgeons perform this operation.
With consistent, conservative management of your cervical herniated disc, you may be able to avoid surgery and successfully resolve this painful condition. When considering surgery, however, be sure to investigate all options.